Expanding surgical access port

ABSTRACT

A surgical access port that includes a cylindrical member having a proximal end and a distal end and defining a longitudinal axis; at least two lumen extending through the cylindrical member along the longitudinal axis; at least one cavity defined in the cylindrical member and positioned radially within the at least two lumen; and a source of inflation fluid coupled to the at least one cavity, the source of inflation configured to permit selectable inflation of the at least one cavity, whereby inflation of the at least one cavity increases the radial distance between the at least two lumen.

CROSS REFERENCE TO RELATED APPLICATION

The present application claims the benefit of and priority to U.S.Provisional Application Ser. No. 61/435,442, filed on Jan. 24, 2011, theentire contents of which are incorporated herein by reference.

BACKGROUND

1. Technical Field

The present disclosure relates to an access port for use in minimallyinvasive surgical procedures, such as endoscopic or laparoscopic-typeprocedures, and more particularly to an expanding surgical access portfor use in minimally invasive procedures.

2. Background of Related Art

Today, many surgical procedures are performed through small incisions inthe skin, as compared to the larger incisions typically required intraditional procedures, in an effort to reduce both trauma to thepatient and recovery time. Generally, such procedures are referred to as“endoscopic”, unless performed on the patient's abdomen, in which casethe procedure is referred to as “laparoscopic”. Throughout the presentdisclosure, the term “minimally invasive” should be understood toencompass both endoscopic and laparoscopic procedures. During a typicalminimally invasive procedure, surgical objects, such as surgical accessports (e.g., trocar and/or cannula assemblies), endoscopes, or otherinstruments, are inserted into the patient's body through the incisionin tissue. Prior to the introduction of the surgical object into thepatient' body, insufflation gasses may be used to enlarge the areasurrounding the target surgical site to create a larger, more accessiblework area. Accordingly, the maintenance of a substantially fluid-tightseal is desirable so as to prevent the escape of the insufflation gasesand the deflation or collapse of the enlarged surgical site.

To this end, various access members are used during the course ofminimally invasive procedures and are widely known in the art. Acontinuing need exists for an access member of a universal size that canbe inserted into a variety of tissue incision sites and expands to fitsuch a variety of larger tissue incision sites. It is desirable toaccommodate a variety of tissue incisions, and adapt to changingconditions at the surgery site.

SUMMARY

In accordance with various embodiments, the present disclosure isdirected toward a surgical access port having at least one internalinflation cavity. The internal inflation cavity is capable of receivingand retaining fluid such that the internal inflation cavity, and thusthe size of the surgical access port as a whole, increases undersupplied inflation fluid. This increase is desirable to cause a moresubstantial seal between the surgical access port walls and the incisionsite, thereby maintaining the insufflated workspace. The surgical accessport may additionally be capable of both radial and axial expansionunder supplied inflation fluid.

The inflation cavity is internal to a cylindrical body that generallyhas an hourglass shape, defines a longitudinal axis, and is coupled to asource of inflation fluid. In use, the operator of the surgical accessport supplies inflation fluid from the source of inflation fluid, andthe internal inflation cavity, and consequently, the body of thesurgical access port expands in response to the supplied fluid. Thedriving force of the inflation fluid may be provided by a pump,reservoir, or any other suitable pressure-generating device. Theinternal inflation cavity is coupled to the source of inflation fluidthrough the use of an inflation coupling that provides a substantiallyfluid-tight seal between the internal inflation cavity and the source ofinflation fluid.

The cylindrical body is formed of a material capable of both expansionand contraction. In embodiments, this material may be foam, or any otherbiocompatible material that is flexible in both radial and axialdirections, yet resilient enough to resist deformation under the stressof the walls of an incision site. The cylindrical body has a proximaland a distal end, both substantially perpendicular to the longitudinalaxis.

Disposed within, and extending through the cylindrical body along thelongitudinal axis, is at least one lumen. The lumen provides a path fromthe proximal end of the surgical access port, through the cylindricalbody, to the distal end of the surgical access port. The lumen or lumensmay also change relative positioning with each other and othercomponents of the surgical access port in response to expansion fromsupplied inflation fluid. Specifically, the lateral spacing betweenlumens with respect to the longitudinal axis will change in response toexpansion of the surgical access port under supplied inflation fluid. Byvirtue of the flexible and compressible nature of the cylindrical body,lumen diameter may be reduced as a result of the expansion of thecylindrical body, and a tighter seal may form about an instrumentdisposed within a lumen. Additionally, the lumens may alter their pathin response to deflection of an inserted instrument relative to thelongitudinal axis.

Also provided is a method for accessing an internal body cavity. Themethod includes the steps of positioning the surgical access port in aninternal body cavity, expanding the surgical access port to a desiredsize with fluid from the source of inflation fluid, and accessing theinternal body cavity via the surgical access port. The surgical accessport allows the passage of surgical tools and other devices into thebody cavity. Removal of the device involves contracting the surgicalaccess port such that it decreases in size so to allow generallyunobstructed removal from an incision site.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a top perspective view of a surgical access port containingfour lumens, a central internal inflation cavity, and an inflationcoupling;

FIG. 2 is top plan cross-sectional view along the line 2-2 of thesurgical access port of FIG. 1, showing four lumens, a central internalinflation cavity, and a first state diameter;

FIG. 3 is a top perspective view of the surgical access port shown inFIG. 1, in a first state and inserted into tissue through an incisionsite, having an inflation coupling and two surgical instruments disposedwithin two of the lumens;

FIG. 4 is a side view of the surgical access port of FIG. 1, as shown inFIG. 3 with two instruments disposed therethrough;

FIG. 5 is a top plan cross-sectional view along the line 2-2 of thesurgical access port as shown in FIG. 2, in a second state and showing acorresponding second state diameter;

FIG. 6 is a side view of the surgical access port shown in FIG. 5 in anexpanded second state and showing a corresponding increase in lumenspacing; and

FIG. 7 is a top plan cross-sectional view of a surgical access porthaving four lumens and four separate internal inflation cavities in afirst state.

DETAILED DESCRIPTION OF EMBODIMENTS

The present disclosure will now describe in detail embodiments of asurgical access port with reference to the drawings in which likereference numerals designate identical or substantially similar parts ineach view. Throughout the description, the term “proximal” will refer tothe portion of the assembly closest to the operator, whereas the term“distal” will refer to the portion of the assembly farthest from theoperator. Although discussed in terms of an incision for a minimallyinvasive procedure, the presently disclosed surgical access port may beused in any naturally occurring orifice (e.g. mouth, anus, or vagina).

Referring initially to FIG. 1, a surgical access port 100 is shown. Thesurgical access port 100 includes a cylindrical member 110 having agenerally hourglass shape, a proximal end 140 a and a distal end 140 b,and defining a longitudinal axis A1. The proximal end 140 a and thedistal end 140 b are substantially perpendicular to the longitudinalaxis A1 and are each surrounded by an outer rim 150 a and 150 b,respectively. Extending through the cylindrical member 110 along thelongitudinal axis A1 is at least one lumen 120, and in embodiments, aplurality of lumens 120. An example of an access port is disclosed inU.S. Patent Application Publication No. 2010/0240960 A1, the entiredisclosure of which is incorporated by reference herein.

Also within the cylindrical member 110, separate from the lumens 120, isan internal inflation cavity 130. The internal inflation cavity 130 maybe symmetrical and centrally disposed as shown here, but in embodiments,may be of shape, plurality, and placement so as to maximize its effecton the surrounding lumens 120. In embodiments, internal inflation cavity130 may be of a generally “X” shape, with rounded edges. The internalinflation cavity 130 extends from some distance along the longitudinalaxis A1 from the proximal end 140 a of the cylindrical member 110, andterminates at some distance along the longitudinal axis A1 before thedistal end 140 b of the cylindrical member 110.

Coupled to the internal inflation cavity 130 is an inflation coupling160, which may be in the form of a tube or a port configured to beattached to the source of inflation fluid 170. The inflation coupling160 is coupled on its distal end to the internal inflation cavity 130,and on its proximal end to a source of inflation fluid 170. The internalinflation cavity 130 will be capable of retaining the inflation fluid.To this end, the internal inflation cavity 130 or the inflation coupling160 may incorporate a structure to control the flow of inflation fluidto the internal inflation cavity. This structure may be a ball valve orother suitable flow control. Additionally, the inflation coupling 160may contain a structure to contribute to maintaining a substantiallyfluid-tight seal with the surgical access port 100. Such structure maybe a press-fit member, bayonet-type, or threaded configuration.

The source of inflation fluid 170 may be any source capable of supplyingthe inflation fluid to the internal inflation cavity 160. Such a capablesource may be a syringe, pump, or reservoir. The source of inflationfluid 170 will supply inflation fluid that is biocompatible and suitablefor surgical procedures, such as CO₂, air, or saline.

In embodiments, a surgical access port 100 may also include a port forthe communication of insufflation fluid to an internal body cavity 220(see FIG. 4). Alternatively, one of the lumens 120 may communicate theinsufflation fluid to the internal body cavity 220.

Turning to FIG. 2, the surgical access port 100 is shown in crosssection along section line 2-2. In this view, each of the lumens 120 canbe seen disposed radially about the internal inflation cavity 130. Thelumens 120 are placed such that an expansion of the inflation cavity 130will cause a shifting in the relative placement of the lumens 120. Sucha shifting may allow greater dexterity and range in performing asurgical procedure with instruments 210 (see FIG. 3) disposed within thelumens 120. When the inflation cavity 130 is not inflated, as shownhere, a first state is defined. In a first state, the inflation cavity130 has an internal pressure that is essentially equalized with that ofthe surrounding environment. A first state diameter D1 is associatedwith the first state, measured transverse to the longitudinal axis A1.

Referring to FIG. 3, the surgical access port 100 is shown in topperspective view inserted into tissue 180 through an incision site 190.The proximal end 140 a of the cylindrical member 110 can be seenextending through the surface of the tissue 180. In this arrangement,surgical instruments 210 can be inserted into lumens 120, and can beseen extending therethrough as shown in phantom view. Also shown inphantom view is the internal inflation cavity 130. Extending through thetop of the proximal end 140 a of cylindrical member 110 is inflationcoupling 160. Thus, the surgical access port 100 in FIG. 3 is shown in afirst, unexpanded, state.

Turning to FIG. 4, a side view of the surgical access port of 100 isshown. In this view, the surgical instruments 210 can be seen extendingcompletely through the lumens 120 (shown in phantom view). Also shown isa relative spacing measurement X1, measured transverse to thelongitudinal axis A1 between the centers of lumens 120, while thesurgical access port 100 is in a first, unexpanded, state.

In use, the operator of the surgical access port 100 will first placethe surgical access port 100 in an incision site 190 such that thesurgical access port is disposed within a layer of tissue 180, as shownin FIG. 3. The operator of the surgical access port 100 will then couplethe inflation coupling 160 to the source of inflation fluid 170,allowing the internal inflation cavity 130 to expand when fluid isintroduced to the internal inflation cavity 130. The source of inflationfluid 170 supplies pressurized fluid to expand the internal inflationcavity 130. This may be accomplished by pumps or reservoirs, or anyother suitable pressure-generating apparatus. The operator of thesurgical access port 100 will allow the internal inflation cavity 130 toexpand such that the walls of the cylindrical member 110 expand to fillthe space between the cylindrical member 110 and the walls of theincision site 190, until a substantially fluid-tight seal is formedbetween the walls of the cylindrical member 110 and the walls of theincision site 190. The surgical access port 100 is then ready forsurgical instruments and tools 210 to be inserted therethrough for usein minimally invasive surgical procedures.

Referring now to FIG. 5, a cross-sectional view along the line 2-2 asshown in FIG. 2 is shown, now with the surgical access port 100 in anexpanded, second state. Here, the second state diameter D2 is shown,clearly different than first state diameter D1. It is also shown thatinternal inflation cavity 130 has expanded and cylindrical member 110has expanded in response.

Turning to FIG. 6, the surgical access port 100 is in an expanded secondstate. The relative spacing measurement X2, measured transverse to thelongitudinal axis between the centers of lumens 120 (shown in phantomview) is clearly different than the relative spacing measurement of thefirst state, X1. As a result, the lumens 120 enjoy greater relativespacing and greater freedom of movement. This greater spacing may alsoprovide access to point in an internal body cavity 220 that may havebeen accessible by the surgical instruments 210 while the surgicalaccess port 100 was in the first state. Additionally, the forces exertedby the expanded surgical access port 100 may also serve to retracttissue outward from an incision site 190. Further, the compressiblenature of the cylindrical member 110 may cause the lumens 120 to form atighter seal about surgical instruments 210 disposed therethrough in thesecond state.

In order to remove the device, the operator of the surgical access port100 will uncouple the source of inflation fluid 170 from the inflationcoupling 160. Surgical instruments and tools 210 will then be removedfrom the lumens 120, and inflation fluid will be released from theinternal inflation cavity 130. This latter step may include opening aplug, seal, or other port in order to release pressurized inflationfluid. The surgical access port 100 will then transition from a secondstate to a first state, with a corresponding decrease in diameter,measured transverse to the longitudinal axis A1. The surgical accessport can then be easily removed from an incision site 180.

Referring to FIG. 7, a surgical access port 200 is shown in a firststate, with four lumens 120 spaced evenly about the longitudinal axisA1, as well as four separate inflation cavities 230, shown here evenlyspaced about the longitudinal axis A1. Separate internal inflationcavities 230 may function to maximize spacing between lumens 120 upontransition of the surgical access port 200 from a first state to asecond state.

It is additionally contemplated that the surgical access port may becoated with any number of medicating substances or materials tofacilitate healing, or to make the use of the surgical access portduring surgery more effective.

It will be understood that various modifications may be made to theembodiments disclosed herein. Therefore, the above description shouldnot be construed as limiting, but merely as exemplifications ofembodiments. Those skilled in the art will envision other modificationswithin the scope and spirit of the present disclosure.

1-9. (canceled)
 10. A method of accessing an internal body cavity,comprising the steps of: positioning a surgical access port in aninternal body cavity, the surgical access port including a cylindricalmember having a proximal and distal end and defining a longitudinalaxis, at least two lumen extending through the cylindrical member alongthe longitudinal axis, at least one cavity defined in the cylindricalmember and positioned radially inwardly of the at least two lumen, andat least one source of inflation fluid coupled to the at least onecavity, the surgical access port having a first state with acorresponding first state diameter defined by the cylindrical memberwith the internal inflation cavity in an unexpanded state and a secondstate defined by the surgical access port with a corresponding secondstate diameter defined by the cylindrical member with the internalinflation cavity in an expanded state; supplying inflation fluid fromthe source of inflation fluid to the at least one internal inflationcavity such that the surgical access port expands from the first stateto the second state, the second state diameter different than the firststate diameter, and wherein, in the second state, the at least two lumenare positioned at a greater radial distance from each other as comparedto the radial distance therebetween in the first state; and accessingthe internal body cavity via the surgical access port.
 11. The method ofclaim 12, wherein the step of accessing the internal body cavityinvolves introducing surgical instruments to the internal body cavity.12. The method of claim 13, wherein the step of accessing the internalbody cavity further includes performing a surgical operation.
 13. Themethod of claim 12, further including the step of retracting tissue atan incision site with the surgical access port in the second state 14.The method of claim 12, further including the step removing surgicalinstruments, releasing inflation fluid from the internal inflationcavity, allowing the surgical access port to transition from a secondstate to a first state, and removing the surgical access port from anincision site.